Temsah Mohamad-Hani, Al-Sohime Fahad, Alhaboob Ali, Al-Eyadhy Ayman, Aljamaan Fadi, Hasan Gamal, Ali Salma, Ashri Ahmed, Nahass Assalh Ali, Al-Barrak Rana, Temsah Omar, Alhasan Khalid, Jamal Amr A
College of Medicine, King Saud University, Riyadh.
Pediatric Intensive Care Unit, Pediatric Department.
Medicine (Baltimore). 2021 May 7;100(18):e25810. doi: 10.1097/MD.0000000000025810.
Research that focuses on transfers to and from the intensive care unit (ICU) could highlight important patients' safety issues. This study aims to describe healthcare workers' (HCWs) practices involved in patient transfers to or from the ICU.This cross-sectional study was conducted among HCWs during the Saudi Critical Care Society's annual International Conference, April 2017. Responses were assessed using Likert scales and frequencies. Bivariate analysis was used to evaluate the significance of different indicators.Overall, 312 HCWs participated in this study. Regarding transfer to ICUs, the most frequently reported complications were deterioration in respiratory status (51.4%), followed by deterioration in hemodynamic status (46.5%), and missing clinical information (35.5%). Regarding transfers from ICUs to the general ward, the most commonly reported complications were changes in respiratory status (55.6%), followed by incomplete clinical information (37.9%), and change in hemodynamic conditions (29%). The most-used models for communicating transfers were written documents in electronic health records (69.3%) and verbal communication (62.8%). One-fourth of the respondents were not aware of the Situation, Background, Assessment, Recommendation (SBAR) method of patients' handover. Pearson's test of correlation showed that the HCW's perceived satisfaction with their hospital transfer guidelines showed significant negative correlation with their reported transfer-related complications (r = -0.27, P < .010).Hemodynamic and respiratory status deterioration is representing significant adverse events among patients transferred to or from the ICU. Factors controlling the perceived satisfaction of HCWs involved in patients, transfer to and from the ICU need to be addressed, focusing on their compliance to the hospital-wide transfer and handover policies. Quality improvement initiatives could improve patient safety to transfer patients to and from the ICU and minimize the associated adverse events.
聚焦于重症监护病房（ICU）出入院患者的研究可能会凸显重要的患者安全问题。本研究旨在描述医护人员在患者出入ICU过程中的操作。这项横断面研究于2017年4月沙特重症监护学会年度国际会议期间在医护人员中开展。使用李克特量表和频率对回复进行评估。采用双变量分析来评估不同指标的显著性。
总体而言，312名医护人员参与了本研究。关于转入ICU，最常报告的并发症是呼吸状态恶化（51.4%），其次是血流动力学状态恶化（46.5%）以及临床信息缺失（35.5%）。关于从ICU转出至普通病房，最常报告的并发症是呼吸状态改变（55.6%），其次是临床信息不完整（37.9%）以及血流动力学状况改变（29%）。用于沟通转院情况的最常用模式是电子健康记录中的书面文件（69.3%）和口头沟通（62.8%）。四分之一的受访者不了解患者交接的现状、背景、评估、建议（SBAR）方法。皮尔逊相关性检验表明，医护人员对医院转院指南的感知满意度与他们报告的与转院相关的并发症呈显著负相关（r = -0.27，P <.010）。
血流动力学和呼吸状态恶化是出入ICU患者中的重大不良事件。需要解决影响参与患者出入ICU的医护人员感知满意度的因素，重点关注他们对全院转院和交接政策的遵守情况。质量改进措施可以提高患者出入ICU的安全性，并将相关不良事件降至最低。
